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Recognize, treat psychiatric comorbidities in patients with hidradenitis suppurativa

Depression and anxiety may be common in patients with hidradenitis suppurativa, although researchers were unable to prove a causal relationship, according to a study in JAMA Dermatology.

“Our results indicate that both comorbidities are common among adults with [hidradenitis suppurativa], although fewer studies assessed anxiety in this population, and hence evidence remains preliminary,” Myrela O. Machado, MD, of the division of dermatology, Women’s College Hospital, Toronto, and colleagues wrote.

The systematic review identified 10 studies with 40,307 patients with hidradenitis suppurativa who were diagnosed by a physician. Studies provided either Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or ICD-10 diagnoses of a depressive disorder or an anxiety disorder.

Overall, depression was prevalent in 16.9% of patients (95% CI, 9.9-27.2), the researchers reported.

In studies that considered a clinical criteria-based diagnosis of depression, the prevalence was 11.9% (95% CI, 4.9-26.2), and in studies that used a screening instrument, the prevalence of probable depression according to the instrument was 26.8% (95% CI, 20.4-34.5).

In studies that used a comparison group, the pooled OR for depression was 1.84 (95% CI, 1.57-2.15).

As for anxiety, four studies were identified, and the overall prevalence was 4.9% (95% CI, 1.7-13.2). The variety between studies was high and represented a study limitation, according to researchers.

The unadjusted ORs were 1.6 and 2.3 in the two studies that included a comparison group. After adjusting for potential confounding variables, the ORs of both were 1.7.

Researchers have not yet assessed depression or anxiety among this patient population through validated structured diagnostic interviews, according to the researchers.

“Efforts should be directed to recognizing and treating those psychiatric comorbidities in patients with [hidradenitis suppurativa] to improve health outcomes,” they wrote. – by Abigail Sutton

Disclosures: Machado reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.